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Physician guide · 2026
FHO+ in 2026: what it means for your medical corporation.
FHO+ took effect on April 1, 2026 under the 2024–28 Physician Services Agreement. It changes how family physicians in Family Health Organizations are paid, and that changes the cash flow, the instalments and the planning inside the professional corporation.
What changed on April 1, 2026
The payment pieces.
| Amount | Item |
|---|---|
| $80 / hr | Time-based pay for direct and indirect patient care and clinical administration ($20 per 15-minute unit). Telephone care from outside the office is $17 a unit, or $68 an hour. Capped at 56 units (14 hours) a day and 240 hours per 28-day cycle, with indirect care and clinical administration together no more than 25% of monthly hours and clinical administration no more than 5% |
| 30%, or 50% | Blended fee-for-service premium on shadow-billed in-basket services. A further 20% — 50% in total — applies to 47 specified in-basket services, retroactive to April 1, 2026 and paid from May 2026 |
| 50% | After-hours premium |
| $4 | Per enrolled patient per fiscal year, prorated daily, for administration — to a maximum of $100,000 per group |
| Ended | The access bonus and outside-use payments |
From the Ministry's OHIP bulletins on the FHO model — 260308, 260309 on the hourly rate and 260502 on the premium update. Confirm your own group's terms with your FHO lead and the OMA.
Inside the corporation
Four things to adjust.
- Cash flow. More of your income now follows hours worked. Re-forecast the year so salary, dividends and debt payments match the new pattern.
- Instalments. If FHO+ raises your income, the corporation's instalments based on last year will fall short. Adjust them and avoid interest.
- Time records. Hours are now a billing input. Keep them the way you would keep any record the Ministry can review.
- Compensation plan. Higher, steadier income may change how much stays in the MPC and the salary-dividend mix. 2026 is already a year to revisit it because of Ontario's July rate cut.
Quick answers
What family physicians ask about FHO+.
When did FHO+ start?
April 1, 2026, under the 2024–28 Physician Services Agreement between the Ontario Medical Association and the Ministry of Health.
Does FHO+ income go through my professional corporation?
If your billings are directed to your medicine professional corporation, FHO+ payments are corporate income in the same way your previous capitation and fee-for-service payments were.
Do I charge HST on FHO+ income?
No. Insured medical services are exempt from HST. Some uninsured services and third-party reports are taxable once you pass the small-supplier threshold.
Should I change my corporate instalments?
If your income has risen under FHO+, yes. Instalments based on the prior year will be too low, and the CRA charges interest on the shortfall.
Source: OHIP InfoBulletin 260308, 2024 Physician Services Agreement — FHO; InfoBulletin 260309 (hourly rate); InfoBulletin 260502 (premium update). General information, not advice for your situation. See also salary versus dividends in 2026.
Want your FHO+ year re-forecast?
Call 647-870-8498 or email info@ghayurtax.com. We will update the instalments and the compensation plan together.